Paying Respects: Inside Death Midwifery and Home Funerals

 

-2Originally titled The Other Side Of The Coin: An Interview with a Death Midwife and published in Issue 17.

Interview by Kelly Gray

Jerrigrace Lyons is a family funeral guide, death midwife, and educator. One of the original pioneers of the home funeral movement, she is a founding member of the Home Funeral Alliance, and the founder and director of Final Passages, through which she guides families and certifies home funeral consultants. She also directs the Home Funeral Ministry, is a Reiki Master and Certified Trager Practitioner. She has been interviewed and reviewed in The Wall Street Journal, USA Today, Mother Earth News, SF Magazine, KRON 4, and CNN Headline News to name a few, and was featured in a new PBS documentary: “A Family Undertaking,” which aired nationally in 2004. On January 22, 2014, Jerrigrace sat down to discuss home funerals with Kelly Gray for SQUAT’s on-going column, The Other Side Of The Coin, to discuss the similarities between birth and death and supporting those being touched by these inevitable experiences.

Kelly Gray: Hi Jerrigrace. Thanks for talking with me today. Let’s start with the basics. What are home funerals?

Jerrigrace Lyons: Thanks to you and SQUAT for interviewing me. The phrase home funeral is one that my friend Janelle and I came up with, when we were co-directors of the Natural Death Care Project, to describe a very ancient tradition that is still in use around the world. It means families taking care of their dead. It’s about honoring their body, their life through loving care and ceremony in their own home. In a way, it can be confused with funeral home, which is what we conventionally use today for taking care of the dead. On the other hand, it’s the perfect way to address the other side of the coin because a home funeral is taking place in the home of the family. When we say funeral, a lot of people conjure up a procession: a hearse, a long line of cars, and so forth. In my mind, a funeral is about commemorating a person’s life and caring for them in death. In a home funeral, the family is able to create a ceremony that might be as simple as washing the body, holding hands with one another and/or the deceased, sitting beside them, and paying their last respects. It doesn’t have to mean anything formal; only that the family has a substantial part in the care of their loved one when they die. The body doesn’t go away on a gurney into a van that takes them to another building and then into a refrigerator. Rather, the family keeps their loved one at home after they take their last breath. They can keep them as long as is right and comfortable for them. It’s giving presence to what’s going on and allows people to give weight and time to connect to what’s happening. It’s a huge right of passage and a huge emotional event.

How did you become a death midwife and one of the grandmothers and leading pioneers of the home funeral movement?

    Nineteen years ago, I had a friend, Carolyn, who was a nurse and Reiki master. One day, she went to work and wasn’t feeling well. They ended up calling 911 and she was pronounced dead on the way to hospital. At the hospital, they went through her purse and there was a card that said “In the event of my death, call Norma Wilcox.” They called and Norma informed them that she was the durable power of attorney for Carolyn, and that Carolyn had written instructions for how she wanted to be cared for when she died. She wanted her body brought home from the hospital, to have her friends wash her body, hold a ceremony in her home, and then drive her body to the crematorium. When I got the message that we were invited to meet that night at Carolyn’s home, even though I was in shock, I said of course I would be there. She had a history of asthma and was under doctor care, the significance of that being the doctor was willing to sign-off on the death certificate with the cause of death being asthma. This meant that we didn’t need to have a coroner do an investigation of her death with an autopsy. If Carolyn had been autopsied, we never would have felt confident enough to bring her home and do the things she had asked us to do.

Why would an autopsy have inhibited you from bringing her home?

     -19In an autopsy, they do an incision down the chest and remove the organs to weigh them. They also make an incision on the scalp and remove the brain. The incision on the head is not sewn up. Then they place all the organs in a plastic bag that is placed back into the body cavity. That cavity is then crudely sewn up. It’s left to the funeral home to stuff the head cavity with something, or not, and they use special screws to screw the skull back together so it doesn’t move. Then they glue the incision so that it looks normal and natural. If an autopsy had been done, we might not have felt that we could handle that particular situation. These days, I’ve helped many families who’ve had loved one’s bodies autopsied. But back then, we might not have done it.

    Norma walked us through Carolyn’s instructions to wash and dress her body at home. She knew it was a matter of doing what felt like common sense – washing her body with warm soapy water. It’s a beautiful ritual for who ever loved the person to wash and honor the temple of the body. It’s the first way in which our bodies have a visceral reaction and our minds connect with “this person has died.” You have two to four hours before rigor mortis sets in, so you can go slow and allow yourself time to process.

    For me, the experience of washing Carolyn’s body was very profound. A message came into my body that something radical had changed. All of us were talking to her as though she could hear us. Many believed that she was orchestrating our care of her and that her great gift to us was teaching us this ancient tradition of preparing her body. Because we had gone to sleep, she was waking us up to how this had always been done.

    -3The next day we were preparing to take her to the crematorium. Someone bought a box of gardenias, her favorite flowers, which we framed her body with. We found a bowl of fortune cookie fortunes and we were taping them to her body, laughing. We found a piece of driftwood and placed it in her hand, and found a bird wing in her bedroom and taped it to her breast – various things that we knew she would have liked. It made sense to send her off with these symbolic representations of nature, life and things she loved. It was very personal. That’s part of the difference with the family being involved and being in the home where these objects are around.

    Many lessons happened over those days and awakened this part of me that I believe all of us have, on a cellular level, this memory of taking care of the dead. It completely diminished my fear about death. Many people that I meet on my speaking tours have memories of their family members, great grandmothers and grandfathers, laid out to rest. So it wasn’t that many generations ago that everyone was doing this.

    At first, I didn’t feel qualified in anyway to teach people about death. At least that’s what I was telling myself. But a year and a half after Carolyn died and I had been telling her story, first in the paper and then to a few groups with a woman from the Redwood Funeral Alliance, I called a group of interested people to my home for our first meeting. We called ourselves the Natural Death Care Project. We wanted to give other people the experience that I had and offer a sane approach to death. Also, economically it made sense. I’d learned a lot about the funeral industry and how much people got charged and it was only going up.

Does this raising cost of conventional funerals affect who seeks out home funerals? Do people come to it because they can’t afford the economic alternative?

    Yes. Many people would choose burial over cremation but they can’t afford it. Right away cost dictates what type of arrangement a person makes. Some people make it based on religion and culture, and some people base it on environment. My dad used to say, “Why use up precious ground that can’t be used for anything else if you stick a body in it?” Green burial is not only about being aware of what you put in the ground. It’s also about preserving it as conserved space. People can walk on trails, have picnics and visit their loved ones in setting surrounded by beautiful, indigenous trees.

If someone wants to pursue a home funeral, what are the biggest obstacles, both logistically and emotionally?

 -15     First, they need to know this approach exists. Next, people have forgotten what this looks like. They usually have no personal experience to know what it is. No one ever sees a dead person lying in a bed with their loved ones holding their hands at home. What we do have is a lot of negative images that give us a fear of death: ghouls, the walking dead, monsters, ghosts, and vampires. We haven’t had a war on U.S. soil since the Civil War, so most people haven’t seen what a body looks like. When my book is done, there will be lots of pictures of peaceful people at the end of lives with their loved ones surrounding them. Not the scary images people think they are going to see when someone dies.

This is so similar to birth. We are fed this cultural narrative about how scary the vagina is, how scary birth is, and we are told it’s a medical emergency to be taken care by someone other than yourself.

     Outsourced to people who know better than us. We’ve been fed it for so long we’ve bought it and believe we are not emotionally capable.

Can you tell me how a home birth might be similar to a home funeral?

     Birth and death are the most important rights of passage that we have. Experiencing them is what gets us through our fear of them. We are empowered by being present for them. Even when they are dramatic, it’s coming through to the other side that makes us strong. Actually, I don’t know if it makes us strong or if it brings forward our innate strength that’s always been there. When that strength is pulled forward we feel like we’ve been a part of something huge and I made it through. Life and death; it’s coming in and going out.

In the birth movement, we often find resistance within the medical community to homebirth. To the extent that they aggressively lobby against a woman’s right to choose where and when she gives birth. Is there a similar resistance to people’s right to choose how they hold funerals?

-6     There is a lot of resistance in this country and it’s allowed the funeral homes to grow as an industry. It started during the Civil War when embalming became popular. As they tried to get the dead soldiers back home, they decided the best way to do that and keep bodies intact was to embalm them. That created the undertaker who said, “We know how to embalm a body and you don’t. Those who know this skill are the only people who have the right to take care of the dead.”

They created a commodity out of taking care of the dead?

     They did. In fact, my friend calls it the “commerce of corpses.” It’s a way for them to say that, because they’re licensed, they’re the only ones qualified to handle a corpse. To support this claim, one of the things they say is that a dead body is a danger to the living.

Is that true?

     No. If you can be exposed to a health risk through a deceased body, you would be more exposed if the person was breathing. Once the body dies, the bacteria begin to die off. There is some controversy over how long it takes to die, but certainly opening a body during the embalming process is far more dangerous. Whether someone has AIDS or MRSA, a body doesn’t become more contagious after death; it becomes less contagious or not at all.

Are the protocols around the paperwork needed for home death and home funerals at a countywide or statewide level?

     It’s statewide but they give some autonomy to county registrar’s offices. For instance, in California, the state law says that the family has the right to file their own paper work, which acts as a transport permit. However, various county offices discourage families from filing their own death certificate simply by saying that they only use the Electronic Death Register System, which is a system that they have devised for funeral directors working from home. They do not give this same right to families. If the family is going to carry out their rights to file the paperwork, they have to do it on a hard copy, either by hand writing it or typing it.

Do the funeral home directors have a lobbying presence?

     Yes. For instance, the funeral home industry in Oregon decided they wanted to force people to only scatter ashes on their privately owned cemetery grounds. Oregon was the only state with this law, and it was in place for 13 years. People felt criminal if they wanted to scatter ashes somewhere else.

It’s as if you don’t have any rights to the body.

     Or the ashes! Which are completely sterile.

It reminds me of birthing at the hospital. You give birth to the baby and then the placenta. They wrap the placenta in a hazardous waste bag and you’re made to feel as if it’s hospital property, not yours as a part of your body. I think those feelings sometimes extend towards the baby; people think that it’s not theirs until they leave the hospital, that the baby is under the authority of the medical team.

-17     Yes! Once you release the body to the funeral home, it becomes their jurisdiction and property. If a family wants to go back and retrieve the body from them, they will allow it but only by charging them for the time they held it.

Who are the people advocating for family rights?

     Not many. In Oregon, there was a lobbyist working against legislation that would have made it illegal to pay home funeral guides. That would be the same thing as saying doulas can help all the women they want, they just can’t get paid for it. They’re trying to block anyone who isn’t licensed from getting paid for helping a family wash the body of a loved one, dress them, anoint them with oil, help them get paperwork filed, or transport bodies.

It’s interesting talking about birth workers and death midwives – how much or how little we get paid – because there is this perception that homebirth is a privilege for wealthy, white women. Right now, it mostly is. In large part, this is due to lack of Medicaid coverage, insurance reimbursements, and families having to pay out of pocket. Could you address the economics of home funerals and whether or not they are accessible for poor and middle class families?

     The law says that anyone can have a home funeral. One of the reasons we wrote our guide book is so anyone can do this and we’ve donated them to libraries and hospice centers. Education is the key for low-income accessibility. Without having a guide, many families feel fearful about birth and death. So, knowledge is key to us to going back to the natural, sensible way of doing things. Which means people like you and me, doulas and midwives, should be walking beside the family so they can feel empowered.

What is your vision for accessibility?

-4     To create a death education center where people could come and learn about all the things having to do with death: building caskets, the laws, and filling out death certificates. Low-income families could have their funerals partially or completely subsidized by donations, corporations, or the government. Why aren’t governments subsidizing funerals when so many people go broke with the cost of healthcare? By the time you get to the death, folks are broke and have to come up with even more money for the funeral. It’s such a painful thought. Just as we have social services for people who need healthcare, we can have the same services for families who want to have that last goodbye be a meaningful experience as opposed to one that forces them to go into debt.

Do you have any advice for low-income families who want to pursue a home funeral?

     They should go to the National Home Funeral Alliance’s directory and look for a home funeral guide who can assist them with resources as well as offer free/low cost fee or by donation.  If there isn’t a guide in your area, call the FCA, the Funeral Consumer Alliance. They give advice on how to get the lowest cost, yet ethical, funeral.

Do you think there are any opportunities for the homebirth and home funeral movement to build a partnership around raising awareness and accessibility?

     My daughter, who is a doula, and I want to create a one day workshop where we discuss the commonalities and challenges of birth and death. Both experiences bring meaning and great love to the families. But we also want to discuss the similar challenges and how we can bring awareness to what has been natural and customary to families for eons. It’s not rocket science to wash a body. It’s about community awareness and support, community skilling and re-skilling. All of these things can be the way back to normal, natural, and sensible approaches.